Provider Demographics
NPI:1477641249
Name:EVERETT TRANSITIONAL CARE SERVICES
Entity Type:Organization
Organization Name:EVERETT TRANSITIONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCRIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-330-3671
Mailing Address - Street 1:PO BOX 13700
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98082-1700
Mailing Address - Country:US
Mailing Address - Phone:425-332-4475
Mailing Address - Fax:425-740-0426
Practice Address - Street 1:916 PACIFIC AVE FL 4
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4147
Practice Address - Country:US
Practice Address - Phone:425-382-2800
Practice Address - Fax:425-740-0426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1245314000000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA505533OtherMEDICARE 6/5/20
WA4116171Medicaid
WA4112454Medicaid